Natural course of idiopathic oligozoospermia: Comparison of mild, moderate and severe forms

Abstract

Objectives:To investigate the natural courses of mild , moderate and severe idiopathic oligozoospermia, and which factors or semen variables were of utmost importance in predicting the courses. Methods: A total of 208 men (age 29-47 years) who were diagnosed with mild , moderate and severe idiopathic oligozoospermia in a 9-year-period between January 2000 and December 2008 were followed up for more than 6 months. Results: Overall, 16 (24.6%) of 65 patients with severe oligozoospermia developed azoospermia, whereas two (3.1%) patients with moderate oligozoospermia developed azoospermia and none of the patients with mild oligozoospermia developed azoospermia. Initial follicle stimulating hormone level and testicular volume between the subgroups were significantly different (P = 0.0071 and 0.0039, respectively). The subgroup of patients who became azoospermic (n = 18) showed statistically significant differences in terms of body mass index and the level of prolactin (PRL) from the subgroup that maintained the initial lingering sperm count (n = 190; P = 0.0086 and 0.0154, respectively). As the vitality of semen variables increased 1%, the risk of progression to azoospermia diminished by 0.892-fold , according to Cox's proportional hazards model analysis. A receiver operating characteristic curve analysis showed that the area under the curve was 0.755 and the sperm concentration value with the highest sensitivity and specificity was the reference value of 3-5 million/mL, with a sensitivity of 0.746 and specificity of 0.711 (P = 0.01). Conclusions: Patients with severe oligozoospermia should be warned of the possibility of becoming azoospermic and hence sperm freezing should be encouraged as early as possible.

Chronic Pelvic Pain Syndrome and Semen Quality of Korean Men in Their Fourth Decade

“…An analysis of the study patients in their fourth decade of life revealed that hormone imbalances may be closely related to the development of CPPS class IIIA and consequently, to poor semen quality. This result is in contrast to recent findings on the role of PRL, low levels of which have been shown to be associated with the metabolic syndrome and arteriogenic erectile dysfunction and with premature ejaculation, anxiety symptoms, and development of azoospermia in men with severe oligozoospermia (Corona et al, 2009; Bak et al, 2010). The LH levels were significantly different between our study patients and controls for reasons that remain enigmatic and warrant further studies.…”

The Emerging Pathophysiology of Age‐related Testicular Degeneration with a Focus on the Stallion and an Update on Potential Therapies

“…In this regard, one study of 208 men with mild, moderate or severe idiopathic oligospermia concluded that those individuals with more severe oligospermia were more likely to progress to complete azoospermia, while those with mild or moderate oligospermia were more likely to remain stable or even improve over time (Won Bak et al 2010). However, the authors made no attempt to determine the cause of these patients' oligospermia and it was not clear how many, if any, were affected by testicular degeneration.…”

Fertility in male medulloblastoma survivors: closing the gaps in counseling

“…20 Further, moderate to severe oligospermia has been shown to progress to azoospermia over time. 11 Therefore, patients with persistent moderate to severe oligospermia after treatment should consider banking their sperm if this was not completed prior to therapy. Medulloblastoma survivors who have received craniospinal irradiation and gonadotoxic chemotherapeutic agents, such as the subjects in our study, may have primary gonadal damage that is underdiagnosed due to follicle-stimulating hormone levels that appear to be "normal" or even low due to superimposed secondary hypogonadism.…”

“…7,8 Additionally, fertility counseling and sperm cryopreservation may help young adults cope with the cancer diagnosis 9 and decrease fears about having children. 10 Unfortunately, sperm banking has been strikingly underutilized, [11][12][13] largely due to inconsistent fertility counseling practices 8,[12][13][14][15] despite guidelines from the American Society of Clinical Oncology and the American Academy of Pediatrics. 16,17 Many barriers to providing adequate fertility counseling for pediatric cancer patients have been identified among practitioners, including urgency to start oncologic treatment, inadequate time and knowledge about preservation options, difficulty due to the sensitive nature of the topic, and lack of age-appropriate facilities for adolescent patients.…”